Meniscal tears

Question 1

what are the functions of menisci?

Answer 1

• shock absorbers of the knee joint

- increase articulating surface area

Question 2

are the menisci attached to the collateral ligaments?

Answer 2

medial - yes

lateral - no

Question 3

what is the common mechanism of meniscal tears in young people?

Answer 3

twisted knee while flexed and weight bearing- symptoms onset straight after

Question 4

what are the different types of meniscal tears?

which is the most common?

Answer 4

vertical 
longitudinal (bucket-handle) --> 
most common 
transverse (parrot-beak)
degenerative

https://teachmesurgery.com/wp-content/uploads/2018/04/Screen-Shot-2018-04-03-at-04.49.55.png

Question 5

how do meniscal tears present?

Answer 5

tearing sensation
intense sudden-onset pain
swelling over 6-12 hrs
clicking/catching/locking

examination:
joint line tenderness
joint effusion 
limited flexion
*Mcmurray's test 
*Apley's grind test

Question 6

what investigations are performed?

Answer 6

X-ray to exclude fracture

MRI - identify type of tear too

Question 7

what is the management of meniscal tears?

Answer 7

conservative:
- rest and elevation with compression and ice
(most small tears <1cm will heal and pain subsides over days)

arthroscopic surgery indicated:

• larger tears
• those remaining symptomatic